What is Borderline Personality Disorder

Dr. Purushothaman
September 26, 2018

The entity Borderline Personality Disorder (Problem) is a very serious mental health issue which is characterized by various symptoms like pervasive instability in the mood state, interpersonal conflicts in relationship, self-image and behavioral problems. This kind of problems will disrupt family, work, long term planning and individual sense of identity. An individual with this kind of disorder will always be at the border of psychosis or neurosis. It is most difficult for them to control their emotions. It is not as frequent as schizophrenia and bipolar. Its incidence is  2% . It is more commonly seen in females than in males. Because of this reason they may suffer a lot from the family relationship. They can’t manage things, this will make their life worse. The people with this kind of personality disorder will be at high risk of self injury. These self-injurious behavior involves cutting, suicidal attempts and they may even end up their life in suicide. Its symptoms are going to be worse in young adulthood. There is a greater chance for the young adult to get suicidal. It will gradually decrease with age. It sometimes needs hospitalization due to suicidal behavior and self injurious behavior. It will also need extensive mental health services. It is not an incurable disease, it will improve gradually. They will be able to lead a productive life. But it will take time. Both client and immediate relatives should patiently wait for a normal life.

Symptoms of Borderline personality
The person who is affected with Borderline Personality Disorder will experience severe anger, depressive state and anxiety and tension which may last from a few hours to many days or may recur in between. There will be impulsive aggression, self injury and drug abuse. There thought may be disrupted and there will be an altered sense of self. These altered thought and sense of self may result in a change in carrier plans. They will frequently change their jobs. They will not keep the friendship for a long time. There will be problems with self identity and values. This will lead to decreased self esteem and self respect. This makes the person feel helpless, hopeless and worthless. As they lack to have a strong passion in anything, they will feel bored and empty. They may sometimes have little idea about who they are. This symptom is more acute when they feel that they lack social support and isolated. They may even make dramatic attempts to avoid their loneliness. They will have unstable pattern of social relationships. There will be intense relationships, but it may be not be persistent due to clients altered mental states. Their way of thinking towards a relationship may change consistently. This means that sometimes they feel idealization and sometimes they feel devalued. This attitude will be mainly towards family and friends. For example, if the person with this type of personality is in deep relationship with another person, a small conflict may result in becoming extremely angry for not caring them.

The notable thing in this type of personality is that in most cases the person can tolerate experiencing these kind of contradictory state at one time. They may shift back and forth between good and bad state. If they stay in good state they will not be aware of the bad state.

They cannot tolerate even mild separation, if they have strong bond or relationship, with the person who is separated. A rejection from immediately related person will also cause the same reaction in the person with this kind of personality. This separation will result in feeling lost or they may even feel worthless. They may even attempt to suicide in severe cases. They also show impulsive behavior like binge eating, horrible sex, excessive spending, etc. It will also occur along with other psychiatric illness like bipolar, depression etc.

Causes of Borderline personality
The main cause of this type of personality is still unknown. The genetic and environmental factors are proven to play a good role in this. It can travel down along the genetic line. People with this kind of disorder will usually have a history of abuse, neglect, separation and sexual abuse in the childhood. In light of all these there should be a series of events which may trigger the personality in the adulthood. Adult clients are more likely to be victims of rape or other crimes. This is due to impulsivity and poor judgment.

The researchers also showed an impaired neural circuit is also contributing in this personality. Our emotions are mostly controlled by Amygdala. The people with this kind of personality disorder usually have problems in this area of the brain.

Treatment of paranoid personality
Psychotherapy is considered to be the first line of treatment in this type of disorder. Group and individual psychotherapies are mostly prescribed.

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